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Good news, bad news for Colo. low-income health clinics

Stimulus now, broke later

Dr. Amy Brown examines 5-month-old Isaac Ramirez with help from Isaac's mother, Katherine, at the Mountain Family Health Center in Glenwood Springs. A new clinic is planned in Rifle, but there may be too little state funding to keep it staffed.
(Hyoung Chang, The Denver Post)

Health clinics for the poor must chop $32.9 million from their budgets at the same time they are receiving millions in stimulus dollars to expand — creating a situation where new buildings may stand empty.

Mountain Family Health Centers received half a million dollars in federal stimulus money to build a new clinic in Rifle, but director Dave Adamson said he's not sure he will be able to staff it. In fact, he may have to cut staff at his existing clinic in Glenwood Springs.

The Metro Community Provider Network clinics will get $1.6 million in new solar panels and medical and dental equipment, but state budget cuts are forcing the director to close three clinics in the next two months — one in Bailey, where there are few other options.

"There was real soul searching, a real 'Is there anything else we can do?' " said David Myers, president of the network, which runs 14 clinics in the metro area. "What's scary is, how will it come back?"

Gov. Bill Ritter cut the $32.9 million from health clinics in this fiscal year's budget as he sought to close a budget gap.

Meanwhile, $16.8 million in federal stimulus money has fueled expansion programs at the same clinics — new buildings, technology and space for mental-health programs.

Colorado's 138 primary-care and dental clinics — run by 15 community health centers — are supported by tax dollars and private donations. They serve about 500,000 low-income people in 55 counties.

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State officials say they are working with the health centers to "mitigate the impact of any cuts on health clinics," said Joan Henneberry, executive director of the state Health Care Policy and Financing Department, in an e-mail. "The economic situation is making it hard for all of our health care providers."

She did not elaborate on what would be done to assist the clinics.

Some may be sent to ER

Adamson has seen a 21 percent increase in poor patients at his clinics in Glenwood and Black Hawk since last year.

"We have a building under design now by architects, but we're not sure if we're going to be able to staff it," he said. "It's a vicious cycle."

Much of Adamson's patient population comes to the clinic for urgent care.

"People come in, they're really sick, they have a terrible sore throat or a high fever," he said. "The bottom line is that we're just going to have to start sending them to the emergency room, where the cost of that visit to society and to the hospital will be much higher than here. . . . We don't have any other choice."

The state budget cuts come as demand in some places has never been higher. Medicaid enrollment statewide is up 14 percent, or 59,000 people, but some clinics are logging patient loads 30 percent and 40 percent higher than last summer.

At High Plains Community Health Center in Lamar, which doesn't even have a growing population base, director Jay Brooke sees 100 new patients "coming in from somewhere" every month.

Brooke received $544,245 to build an adult-care center to help patients with lifestyle issues avoid emergency-room visits. Many of his adult patients battle diabetes, hypertension and asthma. The new building is going to cost about $1 million, and the Colorado Health Foundation paid for the rest.

"The irony is, I have the federal money to cover most of the project, and of course in a year or so when it's done, am I going to be able to operate it?" Brooke said. "Of course we're out here in the boonies, and in the rural area, it's hard to get health care providers anyway."

Foundation offers help

The foundation devoted $1.1 million to four health care expansion projects in cooperation with stimulus dollars. Foundation policy director Lorez Meinhold doesn't want clinics to stand empty and would consider giving some operating money to keep them open.

"We're going to look at the the need and what they think would move the clinic ahead," Meinhold said. "It's our commitment to see more people in these times."